Provider Demographics
NPI:1013081462
Name:TREISTMAN, VIRGINIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:
Last Name:TREISTMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125F COLUMBIA CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-1318
Mailing Address - Country:US
Mailing Address - Phone:914-245-3959
Mailing Address - Fax:914-245-3959
Practice Address - Street 1:125F COLUMBIA CT
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-1318
Practice Address - Country:US
Practice Address - Phone:914-245-3959
Practice Address - Fax:914-245-3959
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY359483-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1872182OtherR.N. LICENSE NUMBER
NY359483-1OtherR.N. LICENSE NUMBER
NY01 265 654Medicaid